James Randy Bentley

Individual provider Active NPI Obstetrics & Gynecology Physician · Mobile, AL

NPI 1912935917 · NPPES record last updated Aug 10, 2010

Key facts

NPI
1912935917
Entity type
Individual (NPI type 1)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
License
9721 (AL)
Practice address
3 Mobile Infirmary Cir
Ste 201
Mobile, AL 36607-3514
Phone
(251) 435-7900
Fax
(251) 435-6261
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9721ALMDSpecialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 9721 AL
Obstetrics & Gynecology Physician 207V00000X 9721 AL Yes

Addresses

Primary practice location

3 Mobile Infirmary Cir
Ste 201
Mobile, AL 36607-3514

Mailing address

3 Mobile Infirmary Cir
Ste 201
Mobile, AL 36607-3514
Phone (251) 435-7900

Other identifiers

IdentifierTypeStateIssuer
51009597OtherALMEDICARE
05525700001OtherALCIGNA
51009597OtherALBLUECROSS BLUESHIELD
528902340MedicaidAL

Other providers in Mobile, AL

All providers in Mobile, AL · Obstetrics & Gynecology Physician in Alabama

Sources for this page

Verify at the official NPI Registry.